Clin Orthop Surg.  2016 Sep;8(3):288-297. 10.4055/cios.2016.8.3.288.

Influence of Glenosphere Design on Outcomes and Complications of Reverse Arthroplasty: A Systematic Review

Affiliations
  • 1Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
  • 2Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA. surena.namdari@rothmaninstitute.com

Abstract

BACKGROUND
Different implant designs are utilized in reverse shoulder arthroplasty. The purpose of this systematic review was to evaluate the results of reverse shoulder arthroplasty using a traditional (Grammont) prosthesis and a lateralized prosthesis for the treatment of cuff tear arthropathy and massive irreparable rotator cuff tears.
METHODS
A systematic review of the literature was performed via a search of two electronic databases. Two reviewers evaluated the quality of methodology and retrieved data from each included study. In cases where the outcomes data were similar between studies, the data were pooled using frequency-weighted mean values to generate summary outcomes.
RESULTS
Thirteen studies met the inclusion and exclusion criteria. Demographics were similar between treatment groups. The frequency-weighted mean active external rotation was 24° in the traditional group and 46° in the lateralized group (p = 0.0001). Scapular notching was noted in 44.9% of patients in the traditional group compared to 5.4% of patients in the lateralized group (p = 0.0001). The rate of clinically significant glenoid loosening was 1.8% in the traditional group and 8.8% in the lateralized group (p = 0.003).
CONCLUSIONS
Both the traditional Grammont and the lateralized offset reverse arthroplasty designs can improve pain and function in patients with diagnoses of cuff tear arthropathy and irreparable rotator cuff tear. While a lateralized design can result in increased active external rotation and decreased rates of scapular notching, there may be a higher rate of glenoid baseplate loosening.

Keyword

Shoulder; Rotator cuff; Replacement arthroplasty

MeSH Terms

Adult
Aged
Aged, 80 and over
*Arthroplasty, Replacement/adverse effects/instrumentation/statistics & numerical data
Female
Humans
Male
Middle Aged
Postoperative Complications
Prosthesis Design
Rotator Cuff/*surgery
*Shoulder Prosthesis/adverse effects/statistics & numerical data
Treatment Outcome

Figure

  • Fig. 1 Flow chart representing the systematic review process used in this study.


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